Spinal Cord Injury Lawyers

What Is an Independent Medical Exam (IME)?

An Independent Medical Exam (IME) is a medical evaluation requested by the Washington State Department of Labor and Industries (L&I) or a self-insured employer (SIE) to review your medical history and accident details, to establish finding, opinions, and conclusions about your physical condition. IMEs are conducted by approved L&I providers and are intended to be objective, so no patient-provider relationship is established. During the exam, the provider will review your medical history and accident details to establish finding, opinions, and conclusions about your physical condition, including:

Evaluation of injury severity: An Independent Medical Exam (IME) aims to provide an objective assessment of the severity of the spinal cord injury, including its physical and functional implications. This evaluation helps determine the extent of impairment and the impact on the individual’s ability to work and perform daily activities.

Unfortunately, IMEs can be problematic. For one, the injured worker does not usually get a say in who conducts their IME. What’s more, L&I doctors are rarely as neutral or objective as they claim. They tend to be more loyal to the insurance company that hired them, and, in many cases, their reports and assessments will try to make the case that an injured worker is fine.

Causation determination: In cases where there may be questions regarding the cause of the spinal cord injury, an Independent Medical Exam aims to establish whether the injury is, in fact, related to the industrial injury or occupational disease. This evaluation is crucial for determining eligibility for workers’ compensation benefits.

Many IME doctors will attempt to claim that the worker’s condition is not related to an industrial injury, but was a pre-existing condition neither aggravated nor sustained at the workplace. Such accusations can massively impact the length and validity of a claim, let alone the potential for any future award and further treatment.

Treatment recommendations: IME reports often include recommendations for medical treatment, rehabilitation, and ongoing care tailored to the specific needs of the injured worker. These recommendations help guide the individual’s recovery process and ensure they receive appropriate care.

Adding Conditions: Sometimes L&I Claims Managers recommend IME exams when a client wants to add a condition to their claim, finding that an accident-related injury took longer to surface. Other times it’s because the industrial injury or occupational illness has caused further complications or aggravated a pre-existing condition.

When one sustains a catastrophic injury to one part of the body, it is easy to miss lesser injuries elsewhere. Additionally, the stress of an industrial injury or occupational illness can often worsen a pre-existing condition. If left untreated, these lesser or former conditions can become a great burden on an injured worker, making the recovery process much longer than it might otherwise have been.

What Is the Impact of an Independent Medical Exam (IME) on Permanent Partial Disability (PPD) Rating?

The findings of an IME can significantly influence the potential PPD rating assigned to a workplace-related spinal cord injury. L&I considers the results of the IME, along with other medical evidence and documentation, in determining the extent of permanent impairment and the corresponding compensation awarded to the injured worker.

How Much Is a Spinal Cord Injury Claim Worth?

In Washington state, the money awarded to a claimant is determined by numerous factors making it difficult to provide an accurate L&I settlement calculator. Factors that determine a settlement or award amount include the date the injury occurred, the severity of the injury, and the steps the injured worker takes to receive the compensation they need.

• Permanent partial disability award: Payment is typically based on the type and severity of the injury and whether an Independent Medical Exam (IME) agrees or disagrees with the physician’s opinion. Washington State L&I updates injury payouts each year based on the cost of living adjustments (COLA); the date of your injury will influence your PPD award amount.

• The seriousness of your disability: Your injury is rated as a percentage in its category or given a value of 1 – 9. Typically, the higher the number, the more significant your injury is. Your PPD award is calculated from those numbers before your case is closed. The Permanent Partial Disability L&I settlement calculator is the PPD Schedule.

• What you’ve done to help yourself: If you’re proactive regarding your workers’ compensation claim and work hard to ensure your claim has the correct information, you could earn more in your award payout.

Is Your Spinal Cord Injury a Third-Party Claim or a Washington State L&I Claim?

Third-Party Claim

A third-party claim is one in which someone other than your employer or co-worker is responsible for your injury. If you have been injured on the job due to someone else’s actions or negligence, you may be entitled to additional compensation through a third-party claim, which combines your L&I claim with a personal injury claim using the same facts.

Unlike workers’ compensation payments, there is no limit to the amount of compensation an injured worker may seek in third-party damages. Third-party claims are private matters and are typically litigated directly with the Washington State Superior Court.

If your spinal cord injury leaves you out of work for an extended period of time,  you may be entitled to compensation for pain, suffering, and lost wages.

Washington State L&I Claim

A Washington state L&I claim results from a workplace injury or occupational disease. An L&I claim is monitored and managed by an L&I Claims Manager who sees the process through from initial claim filing to closure. If all goes as planned, your claim is accepted by L&I, and you will receive certain benefits.

When you are injured or contract certain types of illnesses at work, you are entitled to certain workers’ compensation benefits. You can file an L&I claim in Washington state through the L&I website’s File Fast tool, by calling the L&I office at 877.561.3453, or at your doctor’s office. After you file, it is imperative that you call an experienced L&I attorney to help you navigate the L&I claims process.

What Compensation Can You Recover for Spinal Cord Injuries?

• Medical benefits: L&I medical benefits will cover all medical costs associated with your claim. This can include doctor appointments, treatments, surgeries, occupational therapy, and prescription medications.

• Time-loss benefits: If you are approved for time-loss benefits, you may receive compensation for the lost wages and vocational rehabilitation.

• Damages for pain and suffering: L&I settlement and award amounts vary widely and typically fall into three categories:

1. L&I disability pension: a life-long benefit awarded to injured workers who will never be able to return to any gainful employment due to a severe or life-threatening injury.

2. Permanent partial disability (PPD) award: a one-time sum paid to injured workers when their L&I claim is closed. The worker can re-enter the workforce following a PPD award.

3. Claim resolution settlement agreement (CRSA): an L&I settlement option where all parties agree to close an injury claim for a specified amount. When agreeing to this settlement type, the injured worker exchanges all future L&I benefits, except medical, for the payment.

We understand that many families depend on the income of an injured worker, and our Spinal Cord Injury Lawyers are dedicated to winning the benefits and compensation you are entitled to by law. Our practice was founded on a commitment to advocating for workers’ rights, and we are proud of our record protecting the injured and disabled. Call us today for a Free Case Review with an experienced Intake Specialist and learn how Emery | Reddy may be able to help. No fee unless we recover for you.